Lasmiditan for the Acute Treatment of Migraine

Abstract

Migraine is a leading cause of morbidity and disability worldwide. Triptans were the first migraine-specific drug class developed and have proven efficacy in treatment of this neurological disease. They are however contraindicated in patients with cardiovascular disease and possibly others, owning to their vasoconstrictive properties. This review will focus on lasmiditan, which has been called the first ‘ditan’ and ‘neurally acting anti-migraine agent’, designed to selectively agonize the serotonin 5-HT_1F receptor subtype, providing anti-migraine effects without concomitant vasoconstriction. To date, lasmiditan has proven safe and effective for the acute treatment of migraine in two Phase II and four Phase III trials. Post hoc analysis revealed that the majority of treatment-emergent adverse events were CNS-related, mild-to-moderate in severity and self-limiting. The US FDA label recommends that patients not drive or operate machinery until at least 8 h after taking each dose of lasmiditan.

Lay abstract

Migraine is a leading cause of pain and disability worldwide. Triptans (e.g., sumatriptan) were the first migraine-specific drug class developed and have proven to be effective treatments. Triptans are however contraindicated in patients with heart disease and possibly in some subsets of migraine, due to vasoconstriction concerns. This review will focus on lasmiditan, the first 5-HT_1F receptor agonist or ‘ditan’. It does not carry vasoconstrictive concerns and is safe to use in patients who cannot take triptans. To date, lasmiditan has proven safe and effective for the acute treatment of migraine in multiple medical studies. Data from these studies indicates that the most common adverse effects from lasmiditan were dizziness, tingling and sleepiness. These symptoms were generally mild-to-moderate in severity and self-limiting. The US FDA label recommends that patients not drive or operate machinery until at least 8 h after taking each dose of lasmiditan.

Keywords::

• 5-HT_1F receptor
• 5-HT_1F
• lasmiditan
• migraine treatment
• new migraine treatment
• REYVOW^™

Financial & competing interests disclosure

NM Schuster is on the speaker’s bureau for Eli Lilly & Co and advisory board for Lundbeck and has research funding from the Migraine Research Foundation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Company review disclosure

In addition to the peer-review process, with the author’s consent, the manufacturer of the product discussed in this article was given the opportunity to review the manuscript for factual accuracy. Changes were made by the author at their discretion and based on scientific or editorial merit only. The author maintained full control over the manuscript, including content, wording and conclusions.

Additional information

Funding

NM Schuster is on the speaker’s bureau for Eli Lilly & Co and advisory board for Lundbeck and has research funding from the Migraine Research Foundation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.